Over the years there has been much back and forth about how abortion affects a woman's mental health. From the feminism of the 1960s to the current "safe, legal and rare", we rarely hear about abortion without it being tied to a woman's state of mind. Back in the 1960s, women needed the right to abortion to get rid of their traditional role as mother and caretaker; today we hear countless politicians talk about how hard it is to make the decision to have an abortion.

Recently, mandatory counseling laws have been enacted to expand informed consent to, often, uninformed consent - telling women that abortion causes breast cancer or that she is killing a separate human being. Some of these mandatory counseling laws include provisions about how depressed a woman will be after an abortion (not how depressed she may be...she may also feel elated).

"The best scientific evidence published indicates that among adult
women who have an unplanned pregnancy, the relative risk of mental
health problems is no greater if they have a single elective
first-trimester abortion or deliver that pregnancy," said Brenda Major,
PhD, chair of the task force. "The evidence regarding the relative
mental health risks associated with multiple abortions is more
uncertain."

The task force found that some studies indicate that some women do
experience sadness, grief and feelings of loss following an abortion,
and some may experience "clinically significant disorders, including
depression and anxiety." However, the task force found "no evidence
sufficient to support the claim that an observed association between
abortion history and mental health was caused by the abortion per se,
as opposed to other factors."

The report noted that other co-occurring risk factors, including
poverty, prior exposure to violence, a history of emotional problems, a
history of drug or alcohol use, and prior unwanted births predispose
women to experience both unwanted pregnancies and mental health
problems after a pregnancy, irrespective of how the pregnancy is
resolved. Failures to control for these co-occurring risk factors, the
task force noted, may lead to reports of associations between abortion
history and mental health problems that are misleading.

The report noted that women have abortions for many different reasons
and within different personal, social, economic and cultural
circumstances, all of which could affect a woman's mental state
following abortion. "Consequently," the task force wrote, "global
statements about the psychological impact of abortion can be
misleading."

According to the report, women terminating a wanted pregnancy, who
perceived pressure from others to terminate their pregnancy, or who
perceived a need to keep their abortion secret from their family and
friends because of stigma associated with abortion, were more likely to
experience negative psychological reactions following abortion.

Of course there are lots of women who regret having an abortion, some who become dedicated anti-choice crusaders, like Leslee Unruh. But that doesn't mean that abortion is the wrong choice for everyone and will permanently scare the psyche of every woman (or that only people who have had multiple abortions can support a woman candidate). In fact, if a woman freely chooses abortion and isn't judged for it, it sounds like she'll be much better off. So yes, the pro-choice movement should be involved in post-abortion counseling, but for my money, I'd prefer pre-abortion counseling. This counseling could not only make sure that a woman understands the medical procedure she's about to have, but make sure that she's not being coerced, that she has a support system, that if she has drug, alcohol or violence problems in her life that she is referred for help. These are the efforts we can make if we're interested in improving mental health for women having abortions.

Not like you haven't heard it before (especially if you were hanging out with me this weekend) but vasectomies are totally safe. And because this is my blog, I'll tell you my opinion on vasectomies: I'm all for them. No one really wants me to go into it, but here's a quick rundown, from my perspective. Heterosexual women have menstrual cycles, and all that brings. They also bear the brunt of contraception, from what I gather. Further, they are the ones carrying and birthing children, often breastfeeding them. I don't feel it's an outrageous request for men involved with these women to consider vasectomies as fairly painless and totally reversible procedure. The article talks about how men are squeamish about their boy parts, a concern for which I have little sympathy. Somehow testicles became sacred, while women's fallopian tubes, uterii & etc became medically available. It's a procedure that Jamaican men, for example, do not use. You've heard it before.

Speaking of uteri, you may know my obsession with this from my previous posts, but the Picture of the Day from DCist a few days ago was a woman carrying three fetuses in her two uterii. Awesome!

This week was not only MLK Day, but Roe v. Wade Day. Additionally, I lost another family member to cancer. In any case, there was a lot you should have read about:

Roe v. Wade Day/Abortion:Frances Kissling (formerly of CFFC) and Kate Michelman (formerly of NARAL) wrote an op-ed in the LA Times about abortion, and, really, the shift in perception around abortion. They say that one thing the pro-choice folks need to engage in is a discussion about the "challenges" of the movement, including the judgment of women for getting pregnant in the first place.

Saletan says that pro-choicers need to message abortion with the goal of zero, same as teen pregnancy.

Reproducing:Related to the LA Times op-ed, a study out about Indiana shows that about 80% of black babies are born to unwed mothers. Single mothers have lower levels of education and higher rates of poverty than married mothers, although that doesn't necessarily include those older single moms.

Italy has ruled that it is now legal to do pre-implantation genetic diagnosis of embryos. The ruling, applicable only to the Rome area, will be reviewed by a higher court. Also, don't forget, that in Italy only 3 embryos can be implanted at a time.

So while feminism opened up options for a lot of women, there was an ensuing backlash against feminism, and now there's this embrace of everything under the sun as feminism. Want to walk around with a dog collar being led by your boyfriend? Who's to say that's not feminist? Stripping? Feminist. Housewife? Totally feminist (not by all). I'm not about to make any statements about it right now, but it certainly seems to be a trend that the idea of "choice" whether related to feminism or abortion, is in the eye of the beholder. I mean, is one's choice really off bounds for social comment?

Science:The Pill has an extended effect on preventing ovarian cancer, the number one cause of gynecologic cancer deaths in the United States. Apparently, this is leading folks in the U.K. to renew a call to make the Pill available over-the-counter. Additionally, caffeine decreases the risk of ovarian cancer, while alcohol and tobacco use play no role in it.

As always, there's way more to blog about, but I have to get moving. Have a great weekend!

The big news, I guess, is that Hillary Clinton won the New Hampshire primaries, and most of the women's groups are pretty happy about that.

International:Did y'all see this new Always campaign about young women in Africa? I saw the ad on TV, and the website is through the Canadian affiliate. Anyway, it's been well-documented that the lack of access to toilets is a barrier for girls going to school in Africa. This does, then, affect the ability to care for oneself during menstruation. So while I'd like to be more skeptical, I'm totally eating this up.

There is an effort to increase circumcision among boys in developing countries in order to reduce the spread of HIV. Some compare female circumcision to male circumcision, which I think is crap. They do so based on the thought that male circumcision, like female circumcision, takes away from sexual pleasure. Read and weep, jerks.

Regardless, I don't think you should go around circumcising people by force, which is apparently going on in Kenya. One group circumcises, the other doesn't, so to see who your enemies are in this chaotic region, the penis has been a target.

Spanish abortion clinics are on strike. This is in response to increasing anti-activity, including government inspectors. While this will decrease access for many women, I really do admire this. We would have women come into our clinic so ashamed, and disrespectful, and it's just baffling. Not only because so many women have abortions, but because we lived in an anti-choice state, which continuously put forth anti-choice laws. If the women, partners, and families actually voted, protested, whatever, things could be so different.

Science:The mess in Texas over mandating the HPV vaccine has actually been a good thing, as it has piqued the interest of many parents and teens in the state, leading to an increase in vaccination. In other news, the American Cancer Society has a press release on the vaccine (from May 2007) and screening guidelines (on the bottom). The CDC also has guidelines on cervical cancer screenings, in light of the fact that there is an HPV test, which reduces the frequency of screenings for those who have both normal Pap results and a normal HPV test.

Speaking STIs, there's a mutated strain of chlamydia that is causing some serious problems. The article indicates that the problems are in men's rectums, which I guess means this might be somewhat isolated to the gay male population? In any case, LGV seems to be different than the average garden-variety chlamydia which is easily treated with antibiotics.

More news on what hurts you during pregnancy. Not moderate coffee intake, a new study shows. I feel so badly for pregnant women, what with all the physical changes, plus a list a mile long of restrictions on food, behavior, drinks. And it turns out some of it is bunk.

The Chief Rabbinate of Israel has apparently come out against abortions, calling abortion a "grave sin." According to the Torah, the fetus is not a full-fledged person. Interestingly, while the fetus isn't considered a person for the first 40 days, a boy is not a member of Jewish society until he's 8 days old, and a girl at 30 days.

Gender RolesThe Beeb covers the whole Female Chauvinist Pigs thing, asking if flashing is really empowering? The Economist talks about the value of beauty, saying the intelligence may be linked to beauty. ScienceDaily is also running the same information, I think, but a few weeks later.

ScienceGlaxo's cervical cancer vaccine, Cervarix, is on hold for the time being as the FDA has requested more information. Speaking of cervical cancer, the NCI has said that not having a clean margin after cervical surgery raises the risk of recurrence. Which I thought was old news. I thought the point of cancer surgery was to remove as much cancer as possible...no? How we screen for cervical cancer is changing, as we learn more about HPV. Oh, by the way, the AP decided to run a story saying that the cervical cancer vaccine, a shot, hurts. Ground breaking reporting: shots can hurt.

So I'm watching the post-Thanksgiving morning news shows, debating with myself whether or not it would be a good thing if Roe fell, as many Presidential candidates hope for. On one hand, Roe being overturned would certainly be bad for access to abortion. On the other hand, if voters continuously choose to elect anti-choice legislators, why should they be immune from the consequences of those bad choices. Were Roe to fall, voters as well as legislators would have to walk the walk. Right now, for example, there's a man in Ohio that continuously gets re-elected, and his only issue is abortion. The people of Ohio are insulated by his election in part by the other Ohio legislators, but also, to a large extent, by the federal judiciary, upon whom we too greatly rely on for the protection of our rights. It's probably a little Old Testament of me, but I'm wondering if actually giving these anti-choicers more leeway won't actually mean that people eventually vote against them, once they have to deal with the consequences of the vote...

Parental Rights
In Kansas, a gay man agreed to donate sperm to a friend for artificial insemination. She filed papers to terminate his parental rights, which is appears is the default for Kansas sperm donors. He is fighting, and wants to be involved with the children and pay child support.
In the UK, a woman has received court permission to keep her pregnancy a secret from the man who impregnated her, as it was a one-night stand. The court ruled that she alone has the decision-making power regarding the adoption she seeks.

Happy Halloween! As the end of the year approaches I'm filled with thoughts of what I need to do, want to do, and have to do before the calendar rolls over. Such an arbitrary date, but it means something to me nonetheless. And what about the feminist movement? What have we actually accomplished this year? What's my role in all of this? What do we have left to do? And what can we get done in the next 8 weeks?

It's Cleaning-Out-My-Inbox time, in anticipation of the weekend, and possible crab fest, and being a Cara & Karen Cloud on all things festive. DC Feminist Happy Hour planning in the works for an end of the year bash.

In the news:

Schoolgirls in Britain will get the HPV Vaccine. While the vaccine has great results in clinical trials, we still don't really know how long it works.

J&J settles lawsuit over Ortho-Evra (The Patch) death. Massachusetts is looking at wider clinic buffer zones while Oakland is thinking about instituting them in the first place.

The Seattle Post-Intelligencer runs an absolutely amazing column on abortion in the UK (originally in The Independent) It covers the idea that women "deserve" going through an abortion for "irresponsible behavior", the fact that the delay in access to abortion by anti-choice, misogynistic lawmakers contributes to later-term abortions, and the need for better information and access to contraception. Joan Smith is my crush of the week. Month, maybe.

Some weird news out of Florida: a surrogate mother has been told by the courts that she can keep the baby. This is unusual, because it's my understanding that the intentional parents are usually the legal parents (e.g. those who intended to be the parent, regardless of the biological materials used) although there's no national policy. Anyway, very interesting, and each state handles the issue differently.

Condom testers wanted. Sex lessons part of health lessons for miners in Australia. The influence of the Catholic Church's ban on condoms is helping HIV spread in Latin America. South Africa is recalling million s of condoms.

Earlier this month, the press covered the results of a study that showed the HPV test being a better diagnostic tool than the Pap test for cervical cancer. The study, as mentioned in the press coverage, did not use the Thin Prep test commonly used in the United States, so the results may not be translatable to the US population. Nonetheless, people immediately started asking about payment for the HPV test.

First, most insurance companies cover the HPV test. Second, most state Medicaid programs cover the HPV test (see p.14 of the report). Next, the HPV test is only recommended once every three years and costs approximately $70. Lastly, Congress is planning to introduce a bill including coverage of the HPV test for Medicare beneficiaries (over 65). [p.s. that is my exciting news]

Cancer News:The National Breast Cancer Coalition, which has worked hard to get federal funds for breast cancer research, has launched a site with video and text from Presidential candidates regarding their intended role in fighting breast cancer. The group also recently released a survey on breast cancer awareness. I'm shocked at how little people know about this common and detectable disease. For something like ovarian cancer, I'm not surprised (although I'm not happy) at how little people know. Illinois has expanded its breast an cervical cancer screening program, funded through the National Breast and Cervical Cancer Screening Program. People should really know about this, because what use is knowledge of the symptoms of breast or cervical cancer, without a way to actually treat it?

A subset of cancer news: HPVGov. Schwarzenegger vetoed a bill that would have required some health insurance plans to cover the HPV vaccine. Via RHRealityCheck, Denmark and the UK recommend that all girls get the HPV vaccine. Did we already discuss this? The HPV test is more useful at finding cancer than a Pap test - at least the version of the Pap test researchers used, which is not the same one used in the US. (Again, I'll note that my boyfriend works for the company that has the only FDA approved HPV test in the United States, as a full disclaimer).

Domestic:Speaking of Illinois, apparently the pharmacy refusal clause issue has reached a settlement. The Post reports "Trained technicians or store owners would contact a pharmacist at
another location, then follow his or her directions for dispensing the
morning-after pill."

Birth control at middle school? There are very few 11 to 13 year olds having sex, but those that do are hopefully making informed choices, and need access to safe and effective contraceptives. But wow, 13...does that sound young to anyone, or am I getting old?

India:Two Indian news stories, a country for which I have a special place in my heart. First, unwanted sex common among married women in India. Second, GE says it is willing to do more to reduce the use of ultrasound machines for determining a fetus' sex. It is illegal to use an ultrasound for that purpose in India due to the high rate of sex-selective abortions. Nonetheless, it is possible to get around this law, as is the case with most laws. Especially in developing countries. I did a fair amount of work on rule of law stuff, especially as it relates to human rights in developing countries, which is why I am eternally amused by the man from Ghana who wanted me to ignore Ohio's 24 waiting period for abortion, and give his wife an abortion that day, promising me that he wouldn't tell anyone. Anyway, another story on India is the lack of affordable sanitary pads for menstruation.

Fertility:Low birth weight babies born in the NYC area around 9/11 due to stress. New birth control, for women, of course, and years away. Egg freezing not the number one choice, as the odds aren't fabulous that the egg will survive. Embryos and sperm, as we've discussed, fare much better. Chinese herbs useful for menstrual pain. Kroger offers some Pills for $4.